Fifteen-Year Surveillance of LTR Receiving Pre-Emptive Therapy for CMV Infection: Prevention of CMV Disease and Incidence of CLAD.

Autor:	Piloni D; Pneumology Unit, Internal Medicine and Infectious Diseases Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy., Gabanti E; Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy., Morosini M; Pneumology Unit, Internal Medicine and Infectious Diseases Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy., Cassinelli G; Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy., Frangipane V; Pneumology Unit, Internal Medicine and Infectious Diseases Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy., Zavaglio F; Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy., Oggionni T; Pneumology Unit, Internal Medicine and Infectious Diseases Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy., Saracino L; Pneumology Unit, Internal Medicine and Infectious Diseases Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy., Lettieri S; Pneumology Unit, Fondazione IRCCS Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy., Arbustini E; Laboratories of Genetics, Transplantology and Cardiovascular Diseases, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy., Meloni F; Pneumology Unit, Internal Medicine and Infectious Diseases Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.; Pneumology Unit, Fondazione IRCCS Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy., Lilleri D; Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
Jazyk:	angličtina
Zdroj:	Microorganisms [Microorganisms] 2022 Nov 25; Vol. 10 (12). Date of Electronic Publication: 2022 Nov 25.
DOI:	10.3390/microorganisms10122339
Abstrakt:	The efficacy of pre-emptive therapy in the prevention of cytomegalovirus (CMV) disease and the potential association of CMV infection with the occurrence of chronic lung allograft dysfunction (CLAD) was evaluated in 129 lung transplant recipients receiving pre-emptive therapy based on pp65-antigenemia or CMV-DNA in the blood and in the bronchoalveolar lavage. Seventy-one (55%) patients received pre-emptive ganciclovir/valganciclovir (GCV/VGCV) for CMV infection for a median of 28 (9-191) days. Possible CMV disease occurred in six (5%) patients and was healed after the GCV/VGCV therapy. The cumulative incidence of CLAD was 38% and 54% at 5 and 10 years. Acute rejection and CMV load in the blood (but not in the lung) were independent predictors of the occurrence of CLAD. Pre-emptive therapy is highly effective in preventing CMV disease in lung recipients and does not induce a superior incidence of CLAD compared to what reported for other cohorts of patients who received an extended antiviral prophylaxis.
Databáze:	MEDLINE
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